Eli's Hospice Insider

Published on Fri Mar 14, 2014 PDF

CMS scrambles to get hospice functionality in place for new inquiry system.

You won’t have to switch to the HIPAA Eligibility Transaction System (HETS) quite yet, but you should still be preparing for the change.

The Centers for Medicare & Medicaid Services had originally scheduled termination of access to Common Working File (CWF) eligibility queries in the Fiscal Intermediary Standard System (FISS) Direct Data Entry (DDE), (HIQA, HIQH, ELGA and ELGH screens and HUQA) for April 2014. But now CMS is delaying the date, it says in a newly revised MLN Matters article.

Timeline unclear: No new deadline is set, but “CMS will provide at least 90 days advanced notice of the new termination date,” the agency says in the article.

Full hospice information functionality should be in place before CMS requires the switchover to HETS. “Changes are currently underway in HETS … to return Hospice period information in the same format as CWF,” CMS says in an updated Frequently Asked Question in the article. “When these changes are made, HETS will return all of the information provided by the CWF eligibility queries that is needed to process Medicare claims. These changes will be in place before the termination date for the FISS DDE CWF query access.”

Note: The updated MLN Matters article is at www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1249.pdf.